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Epidemiology and Predictors of Mortality of Traumatic Brain Injury at Kigali University Teaching Hospital Accident and Emergency Department

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Date
2015
Author
Krebs, Elizabeth
Advisor
Thielman, Nathan M
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Abstract

Background:

Traumatic Brain Injury (TBI) is a leading cause of death and disability. TBI patients in low and middle- income countries (LMIC) have twice the odds of death than in high-income countries. There is limited data describing the epidemiology and mortality predictors for TBI in LMIC.

Objective:

Determine epidemiology and predictors of mortality in TBI patients at Kigali University Teaching Hospital Accident and Emergency Department (KUTH A&E).

Methods:

Consecutive, injured KUTH A&E patients were prospectively screened for inclusion by reported head trauma, alteration in consciousness, headache, or visible head trauma. Exclusion criteria were <10 years old, presenting >48 hours after injury, or repeat visits. Data were assessed for association with death using logistic regression. Significant variables were included in an adjusted multivariable logistic regression model then refined via backwards elimination until all variables were significant at P <0.05.

Results:

684 patients enrolled between October 7, 2013 and April 6, 2014. 12 (2%) were excluded due to incomplete data. 81% were male with mean age of 31.5 years (range 10 - 89). Most patients (75%) had mild TBI (Glasgow Coma Score (GCS) 14-15), while 15% had moderate (GCS 9-13), and 10% had severe TBI (GCS 3-8). Multivariable logistic regression and refinement by backwards elimination determined that GCS <14, hypoxia, tachycardia and age >50 years predicted mortality.

Conclusion:

GCS <14, hypoxia, tachycardia and age >50 years were associated with mortality among TBI patients at KUTH A&E. These findings can guide clinicians in prioritizing care for patients at highest risk of mortality.

Type
Master's thesis
Department
Global Health
Subject
Neurosciences
head injury
injury
Rwanda
TBI
traumatic brain injury
Permalink
https://hdl.handle.net/10161/10006
Citation
Krebs, Elizabeth (2015). Epidemiology and Predictors of Mortality of Traumatic Brain Injury at Kigali University Teaching Hospital Accident and Emergency Department. Master's thesis, Duke University. Retrieved from https://hdl.handle.net/10161/10006.
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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

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